Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Hiroshima, Japan.
Department of Oral Surgery, Hiroshima Red Cross & Atomic-bomb Survivors Hospital, Hiroshima, Japan.
Oral Oncol. 2020 Dec;111:104874. doi: 10.1016/j.oraloncology.2020.104874. Epub 2020 Jun 27.
The rare adverse drug reaction MRONJ (medication-related osteonecrosis of the jaw) can be induced by treatment with antiresorptive, antiangiogenic, or immunomodulating agents. Immune checkpoint inhibitors (ICIs; e.g., pembrolizumab) are the standard care for advanced or metastatic cancer patients. Denosumab directed against receptor activator of NF-kB ligand (RANKL) is approved for preventing skeletal-related events (SREs) in cancer patients with bone metastases. The combination therapy of ICIs + denosumab has shown promising efficacy and no unexpected safety issues in metastatic melanoma and lung cancer patients with bone metastases. We present a rare case of advanced mandibular osteonecrosis in an adult female with metastatic lung cancer and bone metastases who received concomitant pembrolizumab + denosumab.
抗吸收、抗血管生成或免疫调节药物治疗可引起罕见的药物相关颌骨坏死（MRONJ）不良反应。免疫检查点抑制剂（ICI；例如，pembrolizumab）是晚期或转移性癌症患者的标准治疗方法。针对核因子 κB 配体受体激活剂（RANKL）的地舒单抗被批准用于预防有骨转移的癌症患者的骨骼相关事件（SRE）。ICI+地舒单抗联合治疗在转移性黑色素瘤和肺癌伴骨转移患者中显示出有希望的疗效，且无意外的安全性问题。我们报告了一例同时接受 pembrolizumab+地舒单抗治疗的转移性肺癌和骨转移的成年女性患者发生的罕见下颌骨坏死病例。
